Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | 000777 | CT |
Y | 222Z00000X | Podiatrist | 000777 | CT |
N | 213EP1101X | Primary Podiatric Medicine | 000777 | CT |
N | 111NR0200X | Radiology | 000777 | CT |
N | 213ER0200X | Radiology | 000777 | CT |
N | 213ES0103X | Foot & Ankle Surgery | 000777 | CT |
NPI | 1790770733 |
---|---|
Provider Name | Dr. Ashley Kirsten Shepard |
First Address | Hartford, CT 06106 |
Second Address | Hartford, CT 06106 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/09/2005 |
Last Update Date | 12/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
030000777CT01 | ANTHEM BCBS (01) | CT |
0322890 | (05) | MA |
077700 | CTCARE (01) | CT |
1176045 002 | CIGNA (01) | CT |
2V3380 | HEALTH NET (01) | CT |
3225079 | AETNA (01) | CT |
P2883933 | OXFORD (01) | CT |
U70803 | (02) |